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Organization
W WALLACE VAUGHT JR MD PC
Active
Organization
W WALLACE VAUGHT JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W WALLACE VAUGHT JR. MD (MD)
(843) 665-2000
Entity
Organization
Contact information
Practice address
800 E CHEVES ST, STE 350, FLORENCE, SC 29506-2650
(843) 665-2000
(843) 669-1701
Mailing address
800 E CHEVES ST, STE 350, FLORENCE, SC 29506-2650
(843) 665-2000
(843) 669-1701
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
13703
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137033
—
SC
Enumeration date
10/19/2007
Last updated
10/23/2007
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